Switching from one area of nursing to another. How hard is it?

llg, PhD, RN · Jan 7, 2010

I hate to say this ... but it really depends on the individual person.

Some people find it easy to adapt to changing environments and situations. They can apply the basic priniciples of nursing learned as a student and apply them to many different types of situations easily. Other people find it hard to move out of their comfort zone. Their ability to function is partially dependent on having the context be similar to what they are used to.

Similarly, some people are comfortable with a variety of types of patients -- others are not.

I am one of those people who takes a while to get comfortable in a new environment. I don't move easily among different settings and different contexts.

Also ... some people may have gotten a great education and lots of experience in a variety of fields in their basic nusing education. Others did not. It's a lot easier to switch into something that you have had experience with in the past ... than to switch into an area that you NEVER had much experience in.

Finally, some people cope better emotionally with the uncertainty that comes with switching than others. By "uncertainty" I mean that ... in their previous specialty, they were experts and confident in their practice. When they switch, they become beginners again for a little while -- unable to make the same expert judgments they made routinely in their old jobs. That loss of expertise is unsettling. It can feel as if the rug has been out from under you. Some people hate that feeling of not being confident and secure in their judgment -- and run back to their old jobs where they felt like they knew what they were doing.

In my Staff Development roles, I have worked with a lot of orientees who were in the process of switching from one specialty to another. Some succeed and some do not -- and it seems very dependent on the personality of the individual person.

For me, the saddest cases were always those people who said, "I always wanted to work in this specialty, but someone told me I should get a couple of years of adult med/surg experience first. Now, that I am here in the job of my dreams, I feel too scared to work as a nurse here. I need to go back to med/surg where I know I won't hurt anybody." When they were new grads, they expected to not know everything. But once they had achieved full competence and confidence in adult med/surg, it was too emotionally difficult for them to go back to the "not-knowing" of a beginner again.

student_nurse_11 · Jan 8, 2010

thanks so much for your insightful reply. it really helps. i'm planning to start off in med-surg like a lot of RNs do after graduating. and i'm 99% certain that i will transition to another speciality/expertise.

I will be graduating 1 year from now and I have one nursing elective to take for next semester. I'm debating between a critical care and an ER introductory course. Can you make any suggestions for me? Could you possibly list the pros and cons of each?! - to the best of your knowledge?

Thanks!

Corinna